Discussion: Health Promotion Model used to Initiate Behavioral Changes

Discussion: Health Promotion Model used to Initiate Behavioral Changes

Discussion: Health Promotion Model used to Initiate Behavioral Changes

Describe a health promotion model used to initiate behavioral changes. How does this model help in teaching behavioral changes? What are some of the barriers that affect a patient’s ability to learn? How does a patient’s readiness to learn, or readiness to change, affect learning outcomes?

Read “Patient-Education Tips for New Nurses,” by Smith and Zsohar, fromNursing 2013(2013).



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Here are so factors that influencing health-promoting behavior are divided into three categories, “individual characteristics and experiences,” behavior-specific cognitions and affects,” and “behavioral outcome .” 

The model also describes eight behavior-specific beliefs which are believed to determine the health-promoting behavior and are proposed as targets for behavior change interventions:  

1) Perceived benefits of action. 

2) Perceived barriers to action. 

3) Perceived self-efficacy. 

4) Activity-related affect. 

5) Interpersonal influences ( including norms, modeling/ vicarious learning, and social support).  

6) Situational influences. 

7) Commitment to plan of action 

8) Immediate completing demands and preferences (alternative behaviors that compete for a person’s attention and time). 

Social media interventions may target one or more of these behavior-specific beliefs, being particularly useful in addressing interpersonal influences and commitment to plan of action. 


Theodore H. Tulchinsky MD, MPH, Elena A. Varavikova MD, MPH, PhD, in The New Public Health (Third Edition), 2014 

This was a good discussion which identified 8 “behavior-specific beliefs” that may determine a patient’s degree of health promotion. This list really shows us the importance of having a good understanding of a patient’s “perception” of factors, and not necessarily reality. In this sense, their “perception” becomes their own individual reality, or patient experience.

Patients need to understand how they feel about the “benefits, barriers, their abilities, their influences, and their commitment levels” as you stated in your post. To take this a step further, patients may turn to Social media in order to form their opinions. This can be very dangerous in a society that is considering platforms like “Tik-Tok” to give accurate information. Nurses must be vigilant in combatting misinformation given to the general public. Both the Community and the Country are connected, and unfortunately, rumors and misinformation tend to spread much more quickly than the Truth does at times.  

The transtheoretical model considers an individual’s readiness to make and maintain behavioral changes as well as the process of behavior change. Planners can use this model to design programs that are based on an individual’s readiness, motivation, and ability.   

There are 5 stages in this model, and they include:  

 Precontemplation — in this stage, the individual has no intention to change behavior within the next six months. The individual may lack knowledge or may have been unsuccessful with previous attempts at a change.  

Contemplation: At this point, a person is considering making a change in behavior within the next six months. However, ambivalence may prevent the individual from moving on to the next stage.  

Preparation: During this phase, the individual works towards implementing a change within the next thirty days.  

Action: An individual is at this stage when their behavioral change is obvious and noticeable for 6 months or less  

 Maintenance: The individual enters the final stage, called the maintenance stage. At this point the behavioral change has lasted more than 6 months.  

Many factors influence a person’s willingness to learn. These may include language, literacy, culture, physiological and psychological factors. It’s always important to assess an individual’s barriers or readiness to learn  


Purdue Extension. (Vicki Simpson) Health and human sciences. https://extension.purdue.edu/extmedia/hhs/hhs-792–w.pdf 

The participatory health model is a great model that has gained popularity in recent times because it involves shared decision making between not just members of the healthcare team and the patient but also the families of the patient or client are involved in decision making in regards to health treatment and treatment options. This model incorporates the evidence based practices recommended by the medical practitioner but also takes into account familial preferences, values and goals towards making the decision (Levy et al., 2016).

This health model is great because as the patient when you are diagnosed with a illness you initially might be in a state of shock and might not be ready to accept the diagnosis yet and thus as a result making healthcare decision becomes incredibly hard to do and essentially that becomes the barrier on the patients ability to learn so involving family with the participatory health model is essential to make sure the best treatment is being followed. 


Levy, S. E., Frasso, R., Colantonio, S., Reed, H., Stein, G., Barg, F. K., & Fiks, A. G. (2016). Shared decision making and treatment decisions for young children with autism spectrum disorder. Academic Pediatrics, 16(6), 571-577. 

I also chose the participatory health model. Having the patient and their families involved with shared decision-making allows the patient to be accountable with their health. When the patient is engaged with health promotion, it makes it easier for health care providers to suggest lifestyle and behavioral changes. Communication is key for behavioral changes to be successful in support of patient and health care provider shared decision-making (Howley, 2018). The participatory model allows patients, families, and health care professionals to communicate when making health decisions that are evidence-based along with the patient’s values.  


 Howley, C. (2018). Communication is the key to the participatory medicine model. PMLive. Retrieved from https://www.pmlive.com/pharma_thought_leadership/communication_is_the_key_to_the_participatory_medicine_model_1226027?SQ_DESIGN_NAME=2 

An example of a health promotion model used to initiate behavioral change is the Pender Health Promotion Model. This model discusses the multifaceted nature of individuals as they interact within their environment in pursuit of health. It helps teach behavioral change by focusing on the three vital areas: “the person’s characteristics and experiences, behavior-specific cognition and affect, and behavioral outcomes” (Khoshnood et al., 2020). The model ascertains that distinct personal characteristics affect behavior. Therefore, modifying the variables that influence behavior through nursing interventions results in behavior change. The model underscores the need to adopt health-promoting behaviors to engender improved health (Whitney, 2018). This model enables one to understand that ill behavior leads to poor health outcomes; hence there is a need to redirect efforts toward teaching health-promoting behavior. 

Some barriers that impede the patient’s ability to learn include socioeconomic barriers, low education levels, illiteracy, and cognitive skills. Socioeconomic barriers encompass a lack of access to the resources necessary to trigger learning and contradictory cultural or spiritual beliefs. In addition, low education levels and illiteracy stifle one’s ability to understand various concepts. A person also needs to be of optimal cognitive functioning to engage in learning. A compromise in one’s cognitive skills jeopardizes the grasping and retainment of information. 

Patients’ readiness to learn or change is a crucial determinant of the learning outcomes. The patient must be receptive to the learning process to achieve the learning outcomes. Conversely, the learning process will be impeded if the patient is unwilling to learn or change (Whitney, 2018). Consequently, the behavior change will not be realized. Therefore, the nurse must adopt measures encouraging learning and change, such as considering the patient’s preferences and alleviating the possible impediments to the learning process. 

Khoshnood, Z., Rayyani, M., & Tirgari, B. (2020). Theory analysis for Pender’s health promotion model (HPM) by Barnum’s criteria: a critical perspective. International journal of adolescent medicine and health, 32(4). https://doi.org/10.1515/ijamh-2017-0160 

Whitney, S. (2018). Teaching and Learning Styles. In Health Promotion: Health & Wellness Across the Continuum. Grand Canyon University. Retrieved from https://lc.gcumedia.com/nrs430v/dynamics-in-nursing-art-and-science-of-professional-practice/v1.1/ 

Health promotion is an act or the process of engaging in a lifestyle that improves or makes for good health. The U.S. government uses the tool ‘Healthy People 2020’ as a foundation for wellness and prevention efforts and a model for measurement… their vision being to have a society in which all people live long, healthy lives (Whitney, 2018).  

One of the health promotion models that help in initiating an individual’s health promotion behavioral changes is the Health Belief Model. The health belief model focusses on the individual’s belief and values as related to sickness and diseases. Their belief influences how much importance they will attach to things like wellness check, importance of good diet and exercise, following health education/health promotion practices as recommended by their healthcare providers. 

While conducting health teaching using the health belief model, the nurse should first assess the need of the individual or the community. Health education will be based on the need or health risk behavior identified. According to (Montanero & Bryan, 2013) the five necessary components for individual change in the health behavior modeled in Rosenstock’s model (health belief model) are, the perceived susceptibility towards health threat; severity of the threat; benefits of action to reduce threat of illness; barriers to initiating preventative action, and ability to take preventative action or self-efficacy” (Whitney, 2018).  Health education will target these perceptions. 

Barriers affecting patients’ ability to learn were patients’ lack of interest in learning, nurses lack of knowledge. Language barrier and lack of education tools, for instance health education brochures does not come in all languages. Other barriers like race, immigration, cultural beliefs, socioeconomic class, education level, individual’s learning styles, all contribute to patient’s ability to learn. 

Patient’s readiness to learn can be seen by their asking questions. Use the different learning styles to teach them. Give them brochures and refer them to some useful websites where they can learn more. 


Galloway, R.D., (2003). Health promotion: Causes, Beliefs and Measurements. Clin Med Res. 2003 Jul;1(3):249-58. doi: 10.3121/cmr.1.3.249. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1069052/  

Whitney, S., (2018). Teaching and Learning Styles. In Health Promotion: Health & Wellness Across the Continuum. (Chapter 1). Grand Canyon University. https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1 

“The HBM suggests that a person’s belief in a personal threat of an illness or disease together with a person’s belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior.” (Boston University School of Public Health, 2019, p.1) The Health Belief Model is used to help health care professionals understand health behaviors. It defines the major factors that impact an individual’s health behaviors. Understanding the components of this model aids health care professionals in providing adequate interventions.  

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